Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition

• Type of Material: Article
• Authors: Heather A. Ward, Imperial College London; Teresa Norat, Imperial College London; Kim Overvad, Aarhus University; Christina C. Dahm, Aarhus University; H. Bas Bueno-de-Mesquita, Imperial College London; Mazda Jenab, International Agency for Research on Cancer; Veronika Fedirko, Emory University; Franzel J. B. van Duijnhoven, National Institute for Public Health and the Environment; Guri Skeie, The Arctic University of Norway; Dora Romaguera-Bosch, Imperial College London; Anne Tjonneland, Danish Cancer Society Research Center; Anja Olsen, Danish Cancer Society Research Center; Franck Carbonnel, Institut National de la Santé et de la Recherche Médicale; Aurelie Affret, Institut National de la Santé et de la Recherche Médicale; Marie-Christine Boutron-Ruault, Institut National de la Santé et de la Recherche Médicale; Verena Katzke, German Cancer Research Center (DKFZ); Tilman Kuhn, German Cancer Research Center (DKFZ); Krassimira Aleksandrova, German Institute of Human Nutrition (DIfE); Heiner Boeing, German Institute of Human Nutrition (DIfE); Antonia Trichopoulou, Hellenic Health Foundation; Pagona Lagiou, Hellenic Health Foundation; Christina Bamia, Hellenic Health Foundation; Domenico Palli, ISPO – Cancer Research and Prevention Institute; Sabina Sieri, Fondazione IRCCS Istituto Nazionale dei Tumouri; Rosario Tumino, ‘Civic-M.P.Arezzo’ Hospital; Alessio Naccarati, Human Genetics Foundation (HuGeF); Amalia Mattiello, Federico II University; Petra H. Peeters, Imperial College London; Elisabete Weiderpass, University of Tromsø – The Arctic University of Norway; Lene Angell Asli, University of Tromsø – The Arctic University of Norway; Paula Jakszyn, Catalan Institute of Oncology; J. Ramon Quiros, Public Health Directorate, Asturias; Maria-Jose Sanchez, Hospitales Universitarios de Granada/Universidad de Granada; Miren Dorronsoro, Public Health Direction and Biodonostia Research Institute – CIBERESP; Jose-Maria Huerta, CIBER de Epidemiología y Salud Pública (CIBERESP); Aurelio Barricarte, CIBER de Epidemiología y Salud Pública (CIBERESP); Karin Jirstrom, Lund University; Ulrika Ericson, Lund University; Ingegard Johansson, Umeå University; Bjorn Gylling, Umeå University; Kathryn E. Bradbury, University of Oxford; Kay-Tee Khaw, University of Cambridge; Nicholas J. Wareham, University of Cambridge; Magdalena Stepien, International Agency for Research on Cancer (WHO-IARC); Heinz Freisling, International Agency for Research on Cancer (WHO-IARC); Neil Murphy, Imperial College London; Amanda J. Cross, Imperial College London; Elio Riboli, Imperial College London
• Language: English
• Date: 2016-07
• Publisher: Cambridge University Press (CUP): PDF allowed
• Publication Version: Final Published Version
• Copyright Statement: © The Authors 2016.
• Final Published Version (URL): http://dx.doi.org/10.1017/S0007114516001859
• Title of Journal or Parent Work: British Journal of Nutrition
• ISSN: 0007-1145
• Volume: 116
• Issue: 2
• Start Page: 316
• End Page: 325
• Grant/Funding Information: The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale and Institut National de la Santé et de la Recherche Médicale (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund and Statistics Netherlands (The Netherlands); Nordic Center of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), PI13/00061 to Granada), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra and ISCIII RETIC (Instituto de Salud Carlos III Las Redes temáticas de investigación cooperativa en salud) (RD06/0020) (Spain); World Cancer Research Foundation ref. 2011/428, AGAUR (Agency for Management of University and Research Grants), Generalitat de Catalunya (exp. 2014 SGR 726), Health Research Funds (FIS Exp PI11/1486) and RD12/0036/0018 and Catalan Institute of Oncology (ICO-IDI-BELL)(Barcelona); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 to EPIC-Oxford) and Medical Research Council (1000143 to EPIC-Norfolk) (UK).; The coordination of EPIC is financially supported by the European Commission (Directorate General for Health and Consumer Affairs; DG-SANCO) and the International Agency for Research on Cancer.
• Keywords: MECHANISMS; Science & Technology; POPULATIONS; Cancer survival; EPIDEMIOLOGY; Nutrition & Dietetics; European Prospective Investigation into Cancer and Nutrition; DIETARY PATTERNS; DISEASE; Cohorts; COLON-CANCER; BUTYRATE; RISK; GROWTH; Diets; Colorectal cancers; Life Sciences & Biomedicine; ASSOCIATION
• Research Categories: Health Sciences, Public Health; Health Sciences, Oncology; Health Sciences, Epidemiology

Abstract

Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (P for heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.